Patient perspectives on psychological care after bariatric surgery: A qualitative study.

Psychological interventions may be effective in improving adherence after bariatric surgery; however, there is limited research on patients' willingness to engage with psychological aftercare. This study aimed to qualitatively explore patient perspectives on psychological services in the bariatric setting. Participants reported believing that psychological care is essential for treatment success and indicated that they wanted support with adjusting to changes in lifestyle, self-identity, and relationships after surgery. Participants suggested that psychological aftercare should be recommended by their medical team and incorporated into standard management after bariatric surgery. These findings can be used to inform the design of services for bariatric surgery patients.

Parents' experiences of information-seeking and decision-making regarding complementary medicine for children with autism spectrum disorder: a qualitative study.

BACKGROUND: Complementary and alternative medicine and therapies (CAM) are widely used by parents of children with autism spectrum disorder (ASD). However, there is a gap in our understanding of how and why parents of children with ASD make decisions about CAM treatment, and how "evidence" influences their decision-making. The aim of this study was to explore views and perspectives on CAM decision-making among parents of children with ASD in Australia. METHODS: Semi-structured interviews were conducted with parents of children with ASD (18 years and under) who were living in Australia. The interviews were digitally recorded, transcribed and then analysed using thematic analysis. RESULTS: Twenty-one parents were interviewed (20 women and one man). The mean age of participants was 43 years, (SD = 5.12 years), the majority of whom were born in Australia (71%), and almost half (43%) had a bachelor degree or higher. Three main themes were identifiedin the thematic analysis. First theme was 'Parents' experiences of researching CAM treatments, the second theme was, "Navigating CAM information and practices", which comprises of the subthemes: Assessing information on CAM treatments' What counts as 'evidence'? and Assessing the impact of CAM treatments on the child - What counts as effective?, and the final theme was, "Creating a central and trustworthy source about CAM". Across themes parents' CAM decision-making was described as pragmatic, influenced by time, cost, and feasibility. Parents also reported that information on CAM was complex and often conflicting, and the creation of a centralised and reliable source of information on CAM was identified as a potential solution to these challenges. CONCLUSION: The development of evidence-based information resources for parents and supporting CAM health literacy may assist with navigating CAM decision-making for children's with ASD.

Experiences of primary healthcare professionals and patients from an area of urban disadvantage: a qualitative study.

BACKGROUND: The health disadvantage in socioeconomically marginalised urban settings can be challenging for health professionals, but strong primary health care improves health equity and outcomes. AIM: To understand challenges and identify needs in general practices in a socioeconomically marginalised Australian setting. DESIGN & SETTING: Qualitative methodology with general practices in a disadvantaged area of western Sydney. METHOD: Semi-structured interviews with healthcare professionals and their patients were transcribed and analysed thematically under the guidance of a reference group of stakeholder representatives. RESULTS: A total of 57 participants from 17 practices (comprising 16 GPs, five GP registrars [GPRs], 15 practice staff, 10 patients, and 11 allied health professionals [AHPs]), provided a rich description of local communities and patients, and highlighted areas of satisfaction and challenges of providing high quality health care in this setting. Interviewees identified issues with health systems impacting on patients and healthcare professionals, and recommended healthcare reform. Team-based, patient-centred models of primary health care with remuneration for quality of care rather than patient throughput were strongly advocated, along with strategies to improve patient access to specialist care. CONCLUSION: The needs of healthcare professionals and patients working and living in urban areas of disadvantage are not adequately addressed by the Australian health system. The authors recommend the implementation of local trials aimed at improving primary health care in areas of need, and wider health system reform in order to improve the health of those at socioeconomic and health disadvantage.

The Influence of Ethnic and Mainstream Cultures on African Americans' Health Behaviors: A Qualitative Study.

BACKGROUND: Culture plays an important role in shaping individuals' health behaviors. This qualitative research examines the relationship between African Americans' ethnic and mainstream cultures and their health behaviors (i.e., food intake and physical activity). METHODS: This study used in-depth semi-structured interview format with a group of 25 African Americans to examine the influence of ethnic and mainstream culture on African Americans' food intake and physical activity. Thematic analysis was used to identify common themes and patterns related to African Americans' health behaviors as well as to report these patterns within data. RESULTS: The present study found that African Americans position both their ethnic and mainstream culture as important influences on their health behaviors pertaining to food intake and physical activity. Most participants reported taking advantage of "the best of both worlds" by engaging in picking and choosing healthy behaviors from both cultures to which they belong, and they perceived preparing healthy makeovers as a way to optimize their health. They also identified a range of practical considerations that can facilitate or hinder engagement in healthy eating and physical activity (e.g., affordability, social support). Participants discussed a number of other positive (e.g., resilience, spirituality) and negative (e.g., experience of discrimination) influences on health behaviors. CONCLUSIONS: African Americans consider both their ethnic and mainstream cultures important in shaping their health behaviors. These cultural influences need to be understood in the context of other psycho-socio-environmental factors that affect individuals' health behaviors. The current study has practical implications for designing health promotion programs for African Americans.